Laboratory of Immunobiology, Center for Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece.
Published: January 2021
AI Article Synopsis
Article Abstract
A central paradigm of immunity is that interferon (IFN)-mediated antiviral responses precede pro-inflammatory ones, optimizing host protection and minimizing collateral damage. Here, we report that for coronavirus disease 2019 (COVID-19) this paradigm does not apply. By investigating temporal IFN and inflammatory cytokine patterns in 32 moderate-to-severe patients with COVID-19 hospitalized for pneumonia and longitudinally followed for the development of respiratory failure and death, we reveal that IFN-λ and type I IFN production were both diminished and delayed, induced only in a fraction of patients as they became critically ill. On the contrary, pro-inflammatory cytokines such as tumor necrosis factor (TNF), interleukin (IL)-6 and IL-8 were produced before IFNs in all patients and persisted for a prolonged time. This condition was reflected in blood transcriptomes wherein prominent IFN signatures were only seen in critically ill patients who also exhibited augmented inflammation. By comparison, in 16 patients with influenza (flu) hospitalized for pneumonia with similar clinicopathological characteristics to those of COVID-19 and 24 nonhospitalized patients with flu with milder symptoms, IFN-λ and type I IFN were robustly induced earlier, at higher levels and independently of disease severity, whereas pro-inflammatory cytokines were only acutely produced. Notably, higher IFN-λ concentrations in patients with COVID-19 correlated with lower viral load in bronchial aspirates and faster viral clearance and a higher IFN-λ to type I IFN ratio correlated with improved outcome for critically ill patients. Moreover, altered cytokine patterns in patients with COVID-19 correlated with longer hospitalization and higher incidence of critical disease and mortality compared to flu. These data point to an untuned antiviral response in COVID-19, contributing to persistent viral presence, hyperinflammation and respiratory failure.
Aim: This study had two aims: to analyze surgical patients with mediastinal cysts and masses according to clinical, histopathological, and surgical types; and compare the impact of the coronavirus disease 2019 (COVID-19) pandemic on these cases.
Methods: A retrospective analysis was conducted on 132 patients who had undergone surgical intervention for mediastinal cysts and masses. Demographic, clinical, and histopathologic data were recorded.
Introduction: The COVID-19 pandemic disrupted global economies, social structures, and public health systems. However, Denmark stood out as an exception, maintaining steady life expectancy during this period. This raises important questions about the factors that strengthened the Danish healthcare system and society against the pandemic's challenges.
Background: Glomerular diseases rank third among the causes of chronic kidney disease worldwide and in Indonesia, and its burden continues to increase, especially regarding the sociodemographic index. Kidney biopsy remains the gold standard for the diagnosis and classification of glomerular diseases. It is crucial for developing treatment plans, determining the degree of histologic changes, and identifying disease relapse.
Background: This study addresses the intricate landscape of racial disparities in healthcare delivery, with a specific focus on surgical procedures. The concern was accentuated by the challenges posed during the COVID-19 pandemic when resources became scarce. Recognizing the potential impact of provider bias in medical decision-making, the American College of Surgeons introduced the Medically Necessary and Time-Sensitive (MeNTS) scoring system.
Benign lipomas are a common medical problem that is not known to regress spontaneously. In addition, vitamin D (VD) is a known regulator of adipocyte proliferation and differentiation. Thus, the purpose of this multi-case study was to determine if optimizing serum 1,25(OH)D3 (VD3) concentrations to the 40-60 ng/mL range would catalyze regression of benign subcutaneous lipomas.
